Loved ones of the passengers who were onboard the missing flight watch a televised press conference on Saturday in Beijing.

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Originally published on March 15, 2014 5:33 pm

It has been more than a week since Malaysia Airlines Flight 370 disappeared, and despite a massive search effort, the whereabouts of the plane and the 239 people on board are unknown.

The airline has told the families and friends of those missing to "expect the worst."

But it's tough for families to grieve without knowing the answer to a crucial question: Could my loved one still be alive?

Dr. Pauline Boss works with people in this kind of situation. She's the author of Loss, Trauma and Resilience and a professor emeritus at the University of Minnesota.

She says the families and friends of the missing are experiencing an "ambiguous loss."

"[It's] the most painful kind of loss there is right now, because you have no assurance of the fate of your loved one," she says.

People suffering with this kind of loss often blame themselves, says Boss. A large part of her job is to remind them that the situation is not their fault. But even as a grief counselor, Boss says there is a limited amount she can do to help. Grieving — and healing — simply take time.

"They aren't going to move forward right now. Right now they're in a survival mode," she says. "The only way I've found that families of the missing move forward is if you allow them to hold the paradox that ambiguity causes.

"At one moment they'll say, 'I think they're at the bottom of the sea.' At another moment they'll say, 'I think perhaps they're alive on an island somewhere.' That is normal. That is natural and typical reactions from ambiguous loss."

Sometimes the ambiguity surrounding the loss persists for a lifetime, or even across generations, says Boss. How one deals with that ambiguity depends in part on culture.

"The problem is that those from very can-do cultures, from very mastery-oriented cultures, are used to having answers to all problems. And this is a case where you'll never have an answer," she says. "If that is the case, that you never have an answer, the only option left is to learn to live with the ambiguity."

Embracing that can be painful, says Boss, but it is ultimately a good thing for those suffering loss.

"They become more resilient and stronger for it. They are aware now that life will not always go their way," she says.

Even if people can personally accept not knowing the fate of their loved ones, they can still experience the social isolation that often comes with the grieving process.

"Society is really rough on the families of the missing. They don't understand quite what to do, and unfortunately what people tend to do therefore is stay away," Boss says. "Please don't stay away from these families. But there isn't much you have to say to them. Your presence will be support enough in many cases."

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Transcript

ARUN RATH, HOST:

Now to the mystery that has captured the world's attention, Malaysia Airlines flight 370, which has been missing for a week now. Today, there are new details, but even more mystery. Malaysia's Prime Minister Najib Razak said evidence now indicates the plane was intentionally diverted, and its communications system switched off.

(SOUNDBITE OF RECORDING)

NAJIB RAZAK: These movements are consistent with deliberate action by someone on the plane.

RATH: A deliberate action, not an accident. But he says there are still many unanswered questions.

(SOUNDBITE OF RECORDING)

RAZAK: Despite media reports that the plane was hijacked, I wish to be very clear, we are still investigating all possibilities.

RATH: Authorities are now investigating passengers and crew. And the search for flight 370 continues but in a new and much larger area. Two hundred and thirty-nine people were onboard that flight. Their families and friends are trapped in a state of suspense unable to answer that crucial question: Could my loved one still be alive?

Dr. Pauline Boss works with people who have a missing loved one. She's the author of "Loss, Trauma and Resilience," and a professor emeritus at the University of Minnesota. When we spoke this week, she had just talked with therapists in Malaysia working with the families of the missing. I asked Dr. Boss about her advice.

DR. PAULINE BOSS: One of the first things you want to tell families like this is that what you're experiencing is an ambiguous loss. And it's the most painful kind of loss there is right now because you have no assurance of the fate of your loved one. And then I add this: It's not your fault. And I add that line because most people who suffer from this kind of loss tend to blame themselves. I should not have told her to go on this flight. I should've gone on this flight myself instead of her. All of these kinds of things go through the minds of the people left behind. And so it's very important to tell them repeatedly it's not your fault.

RATH: But when you have that degree of uncertainty, how do you know how to move forward with coping with that loss?

BOSS: They aren't going to move forward right now. Right now, they're in a survival mode. Eventually, we will hope with family and community support systems that they can move forward. But the only way I found that families of the missing move forward is if you allow them to hold the paradox that ambiguity causes. At one moment, they'll say, I think they're at the bottom of the sea. At another moment, they'll say, I think perhaps they're alive on an island somewhere. That is normal. That is natural and typical reactions from ambiguous loss, from not knowing.

RATH: How does that last over time? Does - do the feelings change? Can the ambiguity persist?

BOSS: Well, the ambiguity persists sometimes for a lifetime, even across generations. The problem is that those of us from very can-do cultures, from very mastery-oriented cultures, are used to having answers to all problems. And this is a case where you'll never have an answer. You might have an answer, but you might not ever have an answer.

If that is the case that you never have an answer, the only option left is to learn to live with the ambiguity. And that's quite a challenge for people who live in a very mastery-oriented culture. However, I've seen it happen over and over again. And what happens when people do learn to embrace the not knowing, they become more resilient and stronger for it.

RATH: What can people do to support those who are going through this kind of ambiguous loss?

BOSS: Oh, I'm glad you asked that question because society is really rough on the families of the missing. They don't understand quite what to do. And unfortunately, what people tend to do, therefore, is stay away. Please don't stay away from these families, but there isn't much you have to say to them. Your presence will be support enough in many cases. Our validation, the validation of society for ambiguous loss is essential for people to move forward.

RATH: That's Pauline Boss. She's a professor emeritus at the University of Minnesota, and she joined us from Minnesota Public Radio in St. Paul. Dr. Boss, thank you so much.